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Biomedical subjects

C von Sydow

Publications and source records attributed to C von Sydow.

13 recordsLinked to original sources

Treatment of acute maxillary sinusitis--comparing cefpodoxime proxetil with amoxicillin.

In order to evaluate the clinical efficacy and tolerance of cefpodoxime proxetil, compared with that of amoxicillin in the treatment of acute bacterial maxillary sinusitis, a randomized, double-blind, parallel group comparative study was performed. A total of 286 adults patients were included at 12 centres, each treatment group consisting of 143 patients. Each patient was treated for 10 days and observed before and after treatment. The observations included clinical, roentgenological, bacteriological and laboratory examinations. At inclusion, the most common pathogens were Haemophilus influenzae (24%) and Streptococcus pneumoniae (17%). In the per protocol analysis, 117 patients in the cefpodoxime group and 113 in the amoxicillin group were evaluable for clinical efficacy. The clinical response rates were 96% and 91%, respectively. The corresponding figures in the intent-to-treat analysis were 130 and 128 patients, with clinical response rates of 93% and 88%, respectively. Cefpodoxime proxetil proved clinically as effective as amoxicillin in the treatment of acute bacterial maxillary sinusitis. It was more effective in eradicating H. influenzae and was more efficient in improving the radiological score. Adverse events were reported in 20% of cefpodoxime cases and in 16% of amoxicillin cases. There was no statistically significant difference between the groups.

Acute Disease↗

Acute traumatic tympanic membrane perforations. Cover or observe?

The influence of a paper prosthesis on healing in acute traumatic tympanic membrane perforations was studied in 60 patients randomly selected for a treatment group or a control group. The majority (42 [70%] ) were seen within two days. All patients were treated with oral antibiotics for ten days. The overall healing rate two months after the trauma was 94% (37 of 39 patients). No significant difference between the study group and the control patients was observed. Intermittent secretion was seen in six patients but did not influence the outcome. The perforations occurred in patients with normally sized mastoid air cell systems as seen on roentgenograms. We conclude that acute traumatic tympanic membrane perforations do not need to be treated routinely with paper patching.

Acute Disease↗

Treatment of acute maxillary sinusitis. Erythromycin base and phenoxymethyl-penicillin (penicillin V).

One hundred patients with acute maxillary sinusitis have been studied. The diagnosis was made clinically and confirmed radiologically, using a roentgenological 6-point score for mucous membrane thickening and secretion. Fifty patients in each group were treated with either erythromycin base or phenoxymethyl-penicillin (penicillin V). The roentgenological state of each sinus was classified on the 1st, 5th, 10th, and 15th day, giving an objective evaluation of the treatment effect. There was no significant difference between the two treatment modes as to therapeutic outcome, and the results are compared with those of a larger material of 1220 patients with acute maxillary sinusitis studied in the same way at Lundby Hospital since 1970 (25 different treatment modes).

Acute Disease↗

Acute maxillary sinusitis--a comparison between 27 different treatment modes.

When comparing the outcome of different treatment modes for acute maxillary sinusitis, the roentgenological examination can be recommended for the objective evaluation as a complement to the clinical examination. Using the occipito-mental projection and an additional occipito-mental side view, the diagnosis can be established in a cheap and simple way, and the treatment effect can be followed during the course of treatment in the form of radiological sinus changes. The treatment outcome of 27 different treatment modes in 1320 cases of acute maxillary sinusitis (2039 maxillary sinuses) was compared. There was little difference between the treatment groups as to therapeutic effect, whether using antral drainage alone, antibiotics alone or the combination of both. Factors other than treatment outcome must be important for the consideration of treatment choice, e.g. pharmacokinetics, administration, dosage, treatment cost, number and type of side effects, etc.

Anti-Bacterial Agents↗

Treatment of acute maxillary sinusitis. V. Amoxicillin azidocillin, phenylpropanolamine and pivampicillin.

One hundred and seventy-five patients with clinical symptoms of acute maxillary sinusitis, the diagnosis confirmed radiologically by mucous membrane thickening and secretion, were consecutively allocated to four different treatment groups: amoxicillin, azidocillin, phenylpropanolamine, and pivampicillin. The cure course was followed up radiologically on days 5, 10, and 15. The outcome of treatment was somewhat more beneficial after 5 days for amoxicillin and after 10 days for azidocillin, but slightly less beneficial with phenylpropanolamine after 10 and 15 days. The numbers of side effects were similar for the different treatment groups. The four treatment modes in question are compared with 19 others previously used in a large material consisting of more than 1000 patients with acute maxillary sinusitis.

Amoxicillin↗

Recurrent and penicillin V-resistant otitis media. A treatment study with amoxycillin/clavulanate and cefaclor.

Clinical and bacteriological studies were performed in 122 children, aged 1-10 years, with recurrent otitis media or failed therapy with phenoxymethyl penicillin. A specimen for bacteriological culture was taken from the nasopharynx in all patients, and in our material Haemophilus influenzae, Branhamella catarrhalis and Streptococcus pneumoniae were equally distributed, each forming one-third of the total bacterial count. Thus, H. influenzae and B. catarrhalis (as well as their betalactamase-producing strains) were found more frequently than is generally reported for acute otitis media. Treatment with amoxycillin/clavulanate (Spektramox) gave a high and satisfactory effect comparable to the treatment result of cefaclor (Kefolor). The eradication of the initial pathogens was achieved to a significantly higher extent with Spektramox than with Kefolor. Both drugs were well tolerated.

Amoxicillin↗

Radiography and ultrasonography in paranasal sinusitis.

In order to analyze whether ultrasonography with a reasonable degree of confidence can replace radiography in the diagnosis of sinusitis, 138 patients with clinical signs of sinusitis were examined with both methods. It was found that maxillary sinus fluid was recognized ultrasonographically with a confidence that increased with the amount of fluid, judged from radiographic examinations. In a sub-group of 45 cases, fluid confirmed by maxillary sinus puncture was detected by ultrasonography in 35/45 sinuses (78%) and by radiology in 38/45 sinuses (84%). In patients with radiographically normal maxillary sinuses, the correlation to ultrasound was good. However, mucosal swelling and polyps or cysts observed at radiography were poorly demonstrated by ultrasonography. In addition, the ultrasound method was not reliable for frontal sinus diagnosis. It was concluded that ultrasonography can be recommended in maxillary sinusitis for follow-up of treatment and as a screening method before sinus radiography.

Adult↗